Background:Catheter ablation (CA) is effective for recurrent episodes of ventricular fibrillation (VF) in Brugada syndrome (BrS). VF development in BrS is associated with several electrocardiogram (ECG) abnormalities. This study investigated changes in ECG parameters in high-risk BrS patients who underwent epicardial CA.

Methods and Results:In all, 27 BrS patients were implanted with an implantable cardioverter-defibrillator (ICD). Patients were divided into 2 groups: (1) an ablation group (n=11) that underwent epicardial CA because of VF recurrence; and (2) a primary prevention (PP) group (n=16) with ICD implantation only. ECG parameters were evaluated before and 12 months after CA and compared with ECG parameters in the PP group. The T wave peak-to-end interval was significantly longer and the number of abnormal spikes in leads V1–V3 at the second, third, and fourth intercostal spaces was greater in the ablation than PP group. After ablation, ST levels and the sum of abnormal spikes in leads V1–V3 were significantly decreased. The mean (±SD) number of ICD shocks decreased markedly during a mean follow-up period of 42.0 months (from 3.8±3.7 to 0.2±0.4/year). Four patients had an ICD shock following the ablation procedure. Greater reductions in ST-segment elevation and abnormal spikes were observed in the group without than with VF recurrence.

Conclusions:Improvements in surface ECG parameters appear to be associated with successful ablation in high-risk BrS patients.

背景：导管消融 (CA) 对 Brugada 综合征 (BrS) 中反复发作的心室颤动 (VF) 有效。BrS 中的 VF 发展与几种心电图 (ECG) 异常有关。本研究调查了接受心外膜 CA 的高危 BrS 患者心电图参数的变化。

方法和结果：总共有 27 名 BrS 患者植入了植入式心脏复律除颤器 (ICD)。患者分为 2 组：（1）消融组（n=11）因 VF 复发行心外膜 CA；(2) 仅植入 ICD 的一级预防 (PP) 组 (n=16)。在 CA 之前和之后 12 个月评估心电图参数，并与 PP 组的心电图参数进行比较。与 PP 组相比，消融组的 T 波峰末间期明显延长，V1-V3 导联第二、三、四肋间异常尖峰的数量更多。消融后，ST 水平和 V1-V3 导联中异常尖峰的总和显着降低。ICD 电击的平均 (±SD) 次数在 42.0 个月的平均随访期内显着下降（从 3.8±3.7 到 0.2±0.4/年）。4 名患者在消融手术后发生 ICD 电击。在没有 VF 复发的组中观察到 ST 段抬高和异常尖峰的更大减少。

结论：表面心电图参数的改善似乎与高危 BrS 患者的成功消融有关。